Provider Demographics
NPI:1679686331
Name:JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES
Entity type:Organization
Organization Name:JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CONEY ISLAND CSS
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:WULF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-372-3300
Mailing Address - Street 1:328 UNION ST
Mailing Address - Street 2:TOP FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4617
Mailing Address - Country:US
Mailing Address - Phone:718-522-4534
Mailing Address - Fax:
Practice Address - Street 1:3602 MERMAID AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224
Practice Address - Country:US
Practice Address - Phone:718-946-7085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP0654161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty